Short- and long-term outcomes after robotic versus open hepatectomy in patients with large hepatocellular carcinoma: a multicenter study-Reference-Cited by-全球学者库

Short- and long-term outcomes after robotic versus open hepatectomy in patients with large hepatocellular carcinoma: a multicenter study

Published:2023-11-17 Issue: Volume: Page:
ISSN:1743-9159
Container-title:International Journal of Surgery
language:en
Short-container-title:

Author:

Zhang Xiu-Ping¹,Jiang Nan¹,Zhu Lin¹²,Lin Zhao-Yi¹,Guo Wei-Xing³,Chen Xiong⁴,Ma Yun-Tao⁵,Zhang Fan⁶,Tang Yu-Fu⁷,Chen Zi-Li⁸,Yan Mao-Lin⁹,Zhao Zhi-Ming¹,Li Cheng-Gang¹,Lau Wan Yee¹¹⁰,Cheng Shu-Qun³,Hu Ming-Gen¹,Liu Rong¹²

Affiliation:

1. Faculty of Hepato-Biliary-Pancreatic Surgery, Chinese People’s Liberation Army (PLA) General Hospital; Institute of Hepatobiliary Surgery of Chinese PLA; Key Laboratory of Digital Hepatobiliary Surgery, PLA, Beijing, China

2. The First Clinical Medical School, Lanzhou University, Lanzhou 730013, China

3. Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China

4. Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China

5. Department of General Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, China

6. Department of Hepatobiliary Surgery, Affiliated Hospital of Binzhou Medical College, Shandong, China Department of Hepato-Biliary-Pancreatic Surgery, Fujian Provincial Hospital, Fujian, China

7. Department of Hepatobiliary Surgery, Northern Theater General Hospital, Liaoning, China

8. Department of Hepatobiliary Surgery, Affiliated Hospital of Guizhou Medical University, Guizhou, China

9. Department of Hepato-Biliary-Pancreatic Surgery, Fujian Provincial Hospital, Fujian, China

10. Faculty of Medicine, the Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China

Abstract

Background: Robotic hepatectomy (RH) is currently widely accepted and it is associated with some benefits when compared to open hepatectomy (OH). However, whether such benefits can still be achieved for patients with large hepatocellular carcinoma (HCC) remain unclear. This study aimed to evaluate the short- and long-term outcomes of patients undergoing RH or OH. Methods: Perioperative and survival data from patients with large HCC who underwent RH or OH between January 2010 and December 2020 were collected from eight centers. Propensity score matching (PSM) was performed to minimize potential biases. Results: Using predefined inclusion criteria, 797 patients who underwent OH and 309 patients who underwent RH were enrolled in this study. After PSM, 280 patients in the robotic group had shorter operative time (median 181 vs. 201 min, P<0.001), lower estimated blood loss (EBL) (median 200 vs. 400 mL, P<0.001), and shorter postoperative length of stay (LOS) (median 6 vs. 9 d, P<0.001) than 465 patients in the open group. There were no significant differences between the two groups in overall survival (OS) and recurrence-free survival (RFS). Cox analysis showed AFP >400 ng/mL, tumour size >10 cm, and microvascular invasion were independent risk factors for OS and RFS. After PSM, subgroup analysis showed that patients with a huge HCC (diameter >10 cm) who underwent RH had significantly lower EBL (median 200.0 vs. 500.0 minutes, P<0.001), and shorter LOS (median 7 vs. 10 d, P<0.001) than those who underwent OH. Conclusion: Safety and feasibility of RH and OH for patients with large HCC were comparable. RH resulted in similar long-term survival outcomes as OH.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Surgery